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1
Guy, Lynette M. « The Meanings of Chronic Pain : Chronic Pain as a 'Biographical Disruption' ». Thesis, Griffith University, 2006. http://hdl.handle.net/10072/368083.
Texte intégralRésumé :
Understanding the meaning that the patient makes of their pain is critical to the effective management of chronic pain. Not only do individual patients with chronic pain have difficulty coping with changes to their bodies and to their way of living, in many cases they also face a future of uncertainty and increasing disability. Over time, having chronic unrelenting pain can bring about a loss of self-identity and self-esteem, with threats to future vocational or career prospects. This has the potential to disrupt previous biographical plans and aspirations, to create a 'biographical disruption', in sociological terms. Full appreciation of the biological, the psychological and social influences on the patient, the biopsychosocial perspective, is important, therefore, to the successful management of those with chronic pain. In current times, when an aging workforce and increasing numbers of disabled adults are placing increased burden on social structures and insurance schemes, successful management of chronic pain is becoming even more important. This study set out to investigate these factors amongst patients and professionals dealing with this condition. Analysis of data from in-depth interviews with treating practitioners and patients in relation to their perceptions of 'success' in pain management, and 'barriers to success' supported the emergence of three distinct patient groups. Patient outcomes were defined in the form of a patient typology, described as: 'Disempowered': those who were disempowered, depressed and remaining dependent upon social benefits and ongoing health care, with a 'disappearing
biography'; 'Empowered': patients who were socially mobile, able to become empowered and 'reclaiming a biography'; and 'Seeking revenge': those seeking validation of their injury, remaining angry and intent on revenge, seeking to regain their 'stolen biography'. These interpretations were a product of interactions with others, which included treating practitioners, insurance company and rehabilitation personnel. The findings of this qualitative study provide original and significant application and elaboration of the concept of 'biographical disruption' to chronic pain management. Findings from this research suggest that social factors have previously been underestimated as determinants of successful outcomes in relation to pain management. Rather than biological and psychological factors, social factors were identified as playing a major role in the development and maintenance of disability, pain and dysfunction in this population.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Public Health
Full Text
2
Nippert, Amy Ruth. « The Expression of Chronic Pain : A Multimodal Analysis of Chronic Pain Patients ». Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/579321.
Texte intégralRésumé :
There is currently no viable objective methods to validate a patient is suffering from chronic pain. In order to investigate the face and voice of chronic pain, a pilot analysis was run using publicly available videos from a dental clinic and neurology clinic. The stimuli include patients discussing their pain in addition to segments where the patients discuss how they feel after an efficacious pain-relieving procedure. The patients in the videos suffer from sciatic pain or pain from temporomandibular joint disorder (TMD) and are real patients who have undergone a physical examination. The relevant sections from the clips were coded using a manual FACs, and a pilot stimulus was run using layered vocal analysis (LVA) software provided by Nemesysco. The results of this experiment provide valuable and applicable insight into the expression of chronic pain. This may be helpful in determining true pain patients from drug and attention-seeking individuals. In addition, these methodologies could provide a way to examine pain in individuals that may not be able to express themselves, including patients with mental disorders. The insights from this experiment suggest that these analytic methods may be applicable for additional study and possible implementation in a medical setting.
3
McDermid, Ann J. « Generalized hypervigilance in chronic pain patients ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ58407.pdf.
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4
Markham, Jennifer Rose. « Coping styles of chronic pain patients for both acute and chronic pain experiences ». Case Western Reserve University School of Graduate Studies / OhioLINK, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=case1057682099.
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5
Wartolowska, Karolina. « Understanding patn processing in chronic pain patients using neuroimaging tools ». Thesis, University of Oxford, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526128.
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6
Mahon, Mary L. « Pain perception in chronic pain patients : a signal detection analysis ». Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/31127.
Texte intégralRésumé :
The purpose of this investigation was to examine the supposition that chronic pain patients (CPPs) have altered pain perception. Two models were examined that led to opposing predictions as to how CPPs would respond to painful stimuli (i.e., the hypervigilance and adaptation-level models). Both predictions have been supported by past research but because of methodological variation and the type of pain disorder studied, it has remained unclear under what circumstances the predictions of these two models may be met.
The responses of pain patients to painful stimuli have been found to vary for patients-with different clinical presentations (i.e. those with and without medically incongruent signs and symptoms). Therefore, the present investigation sought to compare the responses to radiant heat stimuli of sixty CPPs (thirty with and thirty without a medically incongruent pain presentation) to thirty age and sex matched normal control subjects (i.e., pain-tree individuals). Signal detection theory methodology was used in order to separately evaluate sensory sensitivity and the response bias to report sensations as painful. In addition, cognitive and affective factors were assessed in order to identity potential psychological correlates of altered pain perception.
The results of this study indicated that the presence of a medically incongruent pain presentation distinguished patients on their subjective report of disability and to a lesser extent cognitive appraisal and affective distress regarding their pain condition. They did not differ in their responses to painful stimuli. In a post hoc analysis where CPPs were classified into 'organic' and 'functional’ diagnostic groups, significant differences in pain threshold and the response bias to report pain were found. Patients classified as 'organic' had significantly higher pain thresholds compared to normal control subjects and patients classified as 'functional'. Differences in pain threshold were primarily represented by the response' bias to report sensations as painful rather than sensory sensitivity to the stimuli. The 'functional' group had a slightly lower pain threshold than the normal control group but this difference was not significant. The results are discussed in light of the two models of pain perception. The two methods used to classify pain patients are discussed according to their orthogonal characteristics on sensory, cognitive, and affective components.Arts, Faculty of
Psychology, Department of
Graduate
7
Perry, Mark Paul. « Does age moderate self-pain enmeshment in chronic pain patients ? » Thesis, University of Leeds, 2013. http://etheses.whiterose.ac.uk/5505/.
Texte intégralRésumé :
Research has demonstrated that chronic pain can compromise identity by becoming enmeshed and centralised with pain. Pain-identity enmeshment and pain-identity centrality are associated with greater affective distress and poorer chronic pain adjustment. However, the literature infers differences between older and younger individuals in terms of pain adjustment, whereby older adults perceive pain as concomitant of aging and experience this as less biographically disruptive and perceive themselves to be younger than their chronological age, which is associated with greater psychological wellbeing. Research has yet to explore the relationship between perceived age and pain-identity enmeshment and adjustment in chronic pain. The purpose of this research was to investigate age in relation to pain-identity enmeshment and centrality and to examine the predictive value of age in pain adjustment. 90 patients with osteoarthritis (OA) and chronic pain were recruited from a musculoskeletal service. Participants completed standardised measures of pain intensity and perceived control (VAS), pain severity and interference (BPI), acceptance (CPAQ), identity (CES, Possible Selves Interviews), affective distress (HADS), and catastrophising (PCS) and provided information regarding their perceived age. Statistical analysis included; correlation, chi square, analysis of variance and linear regression to investigate potential age differences. Chronological age evidenced few significant relationships with variables of pain adjustment and identity. Perceived age evidenced significant relationships with all variables of adjustment and identity, however, did not statistically predict chronic pain adjustment. However, hoped-for proximity and centrality significantly predicted chronic pain adjustment. The CES demonstrated significant relatedness to enmeshment, although effect sizes were small. Therefore, it appears possible that an individual may experience pain becoming central to their identity yet remain un-enmeshed with pain. These findings indicate the necessity to assess hoped-for proximity and centrality in chronic pain populations across all age groups. This research indicates the potential for incorrectly perceiving expectedness and adjustment ease in old age. The implications of these findings are explored, in conjunction with the limitations of this research and potential areas for further research.
8
Bonathan, C. J. « How do patients understand chronic orofacial pain ? » Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1329456/.
Texte intégralRésumé :
Part one of this volume presents a review of the literature on the relationship between chronic pain and socioeconomic status. It examines the evidence supporting the association and considers the psychological meaning of the findings. Part two consists of a qualitative empirical paper which samples patients with chronic orofacial pain to explore their understanding of their pain and their beliefs and fears about the causes and maintenance of their pain, both before and after an initial consultation at a specialist pain clinic. The final section is a critical appraisal of conducting this thesis. It contains a personal reflection of conducting both the literature review and empirical paper and describes some of the obstacles encountered during the process.
9
Kellen, Rebecca Margaret. « Sleep Patterns and Chronic Pain ». Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc500658/.
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Sleep, emotions and pain are intimately connected,
physiologically, by their location and utilization of the
same brain centers and neurotransmitters. Sleep disturbances
have been clinically observed in chronic pain populations;
yet, no treatment program has formally addressed this aspect
of patient care. It is hypothesized that a pain population
(PN) will differ significantly from a non-injured workforce
(WF) when reviewing quantitative and qualitative sleep data.
This study strongly supports that sleep disturbances and
socioeconomic decrements exist in chronic pain patients.
Forty-seven variables were surveyed and 13 were found to show
significant differences between the groups and seven were
found to discriminate between the PN and WF groups at less than the .0001 level. A discriminant analysis was performed to determine the smallest model which could efficiently classify cases, according to successive root variables. The major discriminators are pain levels, medication, amount of sleep obtained and number of awakenings.
10
Murry, Joe Mitchell. « Ethnicity and Cognitive Complexity of Chronic Pain Patients ». Thesis, University of North Texas, 1990. https://digital.library.unt.edu/ark:/67531/metadc332535/.
Texte intégralRésumé :
Sixty subjects divided equally among Anglo-Americans, Black Americans, and Hispanic Americans participated in the study. They were classified as chronic pain patients by medical diagnosis and duration of pain. They were drawing Workers' Compensation and were all blue-collar workers from the Dallas-Fort Worth area. Cognitive complexity is a measure of individuals' ability to construe their feelings, events of their lives, and their world in a meaningful manner. Cognitive complexity appeared to differ among the cultural groups as indicated by significantly different functionally independent construct scores. Anglo-Americans appeared to have a greater internal complexity than did Black Americans and Hispanic Americans.
11
Hinnant, Donald Wayne. « Cognitive Coping Strategies with Chronic Back Pain Patients ». Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331556/.
Texte intégralRésumé :
Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.
12
Young, Constance M. « The effects of yoga on patients chronic pain ». Online version, 2004. http://www.uwstout.edu/lib/thesis/2004/2004youngc.pdf.
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13
Dehghani, Mohsen. « Cognitive behavioural models of chronic pain & ; the role of selective attention ». Connect to full text, 2003. http://hdl.handle.net/2123/584.
Texte intégralRésumé :
Thesis (Ph. D.)--University of Sydney, 2004.Title from title screen (viewed 6 May 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Psychology. Degree awarded 2004; thesis submitted 2003. Includes bibliographical references. Also available in print form.
14
Ferguson, Brenda Leigh. « Coping strategies of chronic and acute pain patients : Clinical and experimental pain ». Thesis, University of Ottawa (Canada), 1990. http://hdl.handle.net/10393/5682.
Texte intégralRésumé :
The present investigation sought to investigate the coping strategies of chronic pain, acute pain patients and pain-free controls in three areas: (1) Clinical pain; (2) Experimental acute pain and (3) Non-pain stressors. Clinical pain coping strategies were assessed with the Coping Strategy Questionnaire (CSQ) while coping with a non-pain stressor was assessed by the Ways of Coping. Experimental acute pain was induced with a pressure pain device. Pain tolerance and pain ratings were taken. Following the acute-pain induction procedure, each subject's cognitions were scored and rated for the presence of two types of cognitions: catastrophizing and non-catastrophizing. The results indicated that non-catastrophizers kept their finger in the pain apparatus longer and rated the sensations as less painful. No significant differences however, were found among the three groups with respect to pain tolerance, pain ratings or cognitive style. The chronic pain group scored higher than the control group on a subscale measuring catastrophizing strategies. (Abstract shortened by UMI.)
15
Nite, Leesa C. (Leesa Celeste). « Cognitive Decline in Chronic Pain Patients : A Neuropsychological Evaluation ». Thesis, University of North Texas, 1990. https://digital.library.unt.edu/ark:/67531/metadc331398/.
Texte intégralRésumé :
The purpose of the present study was to investigate cognitive functioning in a group of 30 chronic pain patients (CPG) as compared to a group of 39 acute pain patients (APG). In order to assess cognitive performance, certain subtests were selected from the McCarron-Dial System (MDS) of Neuropsychological Evaluation. Specifically, a measure of haptic discrimination was used along with the Bender Visual Motor Gestalt Test. As such, completion of these subtests required a cortically mediated, central nervous system processing of sensory information. This particular method of assessment was chosen because it provided a nonverbal measure of higher-order cognitive performance. Additionally, the haptic measure provided separate scores for right and left hemispheric functioning. Data analysis revealed significantly poorer Bender performance among CPG members (t(69) = -5.09, E - •0004, two tailed). Further data analysis revealed that the CPG performed significantly poorer on certain of the haptic discrimination subtests. Specifically, both texture and configuration scores for the right hemisphere were significantly lower among CPG members (texture, p = -042 and configuration, p = .002). Subsequent analyses were conducted to determine predictive relationships between important variables. These data are discussed in terms of their clinical significance and importance for future research.
16
Frank, Yael Sheine. « Towards an understanding of the chronic pain experience for six former patients of a chronic pain program / ». The Ohio State University, 1997. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487942739808833.
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17
Cascarilla, Elizabeth A. « Chronic Pain-Related Distress & ; Disability : An Empirical Investigation of a Modern Behavioral Theory of Acceptance of Chronic Pain ». University of Akron / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=akron1257472306.
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18
Sorrell, John T. « Effects of pain and fear stimulus intensity levels on pain responding in chronic pain patients ». Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1712.
Texte intégralRésumé :
Thesis (M.A.)--West Virginia University, 2000.Title from document title page. Document formatted into pages; contains viii, 61 p. : ill. Includes abstract. Includes bibliographical references (p. 23-27).
19
Lockart, Esther. « Massage Therapy : Mind/Body Effects on Chronic Pain Patients ». Thesis, University of North Texas, 1988. https://digital.library.unt.edu/ark:/67531/metadc500701/.
Texte intégralRésumé :
This study assessed the influence of massage therapy on the psychobiology of chronic pain patients. A pre- and posttest design measured the effects of a one-month treatment program Twenty outpatients and twenty inpatients of two chronic pain treatment programs, were administered several psychological and physiological tests before and after the study. Experimental subjects received massage therapy twice a week for one month in addition to their other therapies. Control subjects continued with their regular treatment modalities for one month. Results showed statistically significant differences (p < .05) on 5 of the 17 psychological variables and on the electromyograph levels. Analysis of Holmes-Rahe scores suggested that these differences were not attributable to the artifact effect of differential life stress.
20
Martel, Marc. « The intrapersonal and interpersonal dimensions of pain expression in patients with chronic pain ». Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=110566.
Texte intégralRésumé :
Pain behaviour refers to the various actions or postural displays that are enacted during the experience of pain. In patients with pain, the expression of pain behaviours has been associated with a number of adverse pain-related outcomes, including higher levels of functional disability, and longer duration of occupational disability following work injury. Further, there is considerable anecdotal evidence indicating that patients who present with heightened levels of pain behaviours encounter the risk of being perceived as exaggerating or faking pain. The overarching goal of the present thesis was to explore the various intrapersonal (Study 1) and interpersonal (Studies 2 and 3) dimensions that may be associated with the expression of pain behaviours. The primary purpose of Study 1 was to examine the temporal stability of pain behaviours in patients with chronic back pain. Of interest was to examine whether the stability of pain behaviours could be accounted for by patients' sex, pain severity, or pain-related psychological factors. In this study, patients (n = 70) were videotaped on two separate occasions while performing a standardized lifting task designed to elicit pain behaviours. Taken together, results of this study provided evidence for the stability of pain behaviours in patients with chronic back pain. Results further showed that the stability of patients' pain behaviours could not be entirely accounted for by patients' sex, pain severity, or pain-related psychological factors.In Study 2, participants (i.e., observers; n = 70) watched video sequences of patients with chronic back pain performing a standardized lifting task designed to elicit pain behaviours. Following each video sequence, observers were asked to make judgments about patients' levels of pain intensity and readiness to work. For each patient, observers were also asked to make judgments about personality traits relevant to work performance and employment. The primary purpose of Study 2 was to examine the influence of different forms of pain behaviours (e.g., communicative, protective) on observers' judgments about patients' pain intensity and readiness to work. Results indicated that patients displaying either communicative (e.g., facial expressions) or protective (e.g., guarding) pain behaviours were perceived as having significantly more pain than patients displaying no pain behaviour. Interestingly, results indicated that patients displaying protective pain behaviours were perceived as being significantly less ready to work than patients displaying communicative pain behaviours. Follow-up analyses indicated that pain behaviours also exerted a significant influence on observers' judgments about patients' personality traits. In Study 3, participants (i.e., observers; n = 90) watched video sequences of chronic pain patients performing a standardized lifting task. In one condition, observers were asked to make judgments about patients' levels of pain intensity. In a second condition, suspicion was raised about the genuineness of patients' pain and observers were asked to make judgments about patients' levels of faking. The primary purpose of Study 3 was to examine the relative importance of pain behaviours and judgmental heuristics (e.g., gender stereotypes) in observers' inferences about pain intensity and pain genuineness (i.e., faking). Results indicated that observers relied on pain behaviours and judgmental heuristics both when making inferences about pain intensity and when making inferences about pain genuineness. Results, however, indicated that observers reduced their reliance on gender stereotypes and increased their reliance on patients' pain behaviours once suspicion was raised about the genuineness of patients' pain. Follow-up analyses revealed that observers relied significantly more on communicative pain behaviours than on protective pain behaviours when making judgments about the genuineness of patients' pain.Le but général de cette thèse visait à explorer les dimensions intra-personnelles (Étude 1) et inter-personnelles (Études 2 et 3) liées à l'expression de la douleur. L'objectif principal de l'étude 1 était d'examiner la stabilité temporelle des comportements de douleur (ex: expressions faciales) chez des patients ayant une douleur lombaire chronique. Nous étions intéressés à examiner si la stabilité des comportements de douleur pouvait être attribuable au sexe des patients, à la sévérité de la douleur des patients, ou aux facteurs psychologiques des patients. Dans cette étude, des patients (n = 70) ont été filmés à deux occasions distinctes alors qu'ils performaient une tâche visant à susciter des comportements de douleur. Dans l'ensemble, les résultats de cette étude ont supporté la stabilité temporelle des comportements de douleur chez les patients ayant une douleur lombaire chronique. Les résultats ont aussi révélé que la stabilité des comportements de douleur n'était pas entièrement attribuable au sexe, à la sévérité de la douleur, ou aux facteurs psychologiques des patients.Dans l'étude 2, des participants (observateurs; n = 70) ont visionné des séquences vidéo de patients ayant une douleur lombaire en train d'exécuter une tâche provoquant de la douleur. Suite à chacune des séquences vidéos, les observateurs devaient juger le niveau de douleur ainsi que le niveau de capacité à travailler des patients. Les observateurs ont aussi été invités à effectuer des jugements par rapport aux traits de personnalité des patients présentés dans les séquences vidéos. Les résultats ont indiqué que les patients exprimant soit des comportements de communication (ex: grimaces) ou de protection (ex: se frotter le dos) ont été perçus comme ayant significativement plus de douleur que les patients n'exprimant aucun comportement de douleur. Les résultats ont aussi indiqué que les patients exprimant des comportements de protection ont été perçus comme étant significativement moins 'capables' de travailler que les patients exprimant des comportements de communication. Des analyses subséquentes ont indiqué que les comportements de douleur ont aussi exercé une influence significative sur les jugements des observateurs quant aux traits de personnalité des patients.Dans l'étude 3, les participants (observateurs; n = 70) ont visionné des séquences vidéo de patients ayant une douleur lombaire en train d'exécuter une tâche provoquant de la douleur. Dans une première condition, les observateurs ont jugé le niveau de douleur des patients présentés dans les séquences vidéos. Dans une deuxième condition, un doute a été soulevé quant à l'authenticité de la douleur des patients, et les observateurs ont été invités à juger le niveau d'authenticité ('faking') de chacun des patients présentés dans les séquences vidéos. L'objectif principal de l'étude 3 était d'examiner l'impact des comportements de douleur et des stéréotypes de genre (sexe) lorsque les observateurs effectuent des jugements liés à la douleur et à l'authenticité de la douleur d'autrui. Les résultats ont indiqué que les observateurs ont utilisé les comportements de douleur ainsi que les stéréotypes de genre afin de juger l'intensité de la douleur ainsi que le niveau d'authenticité des patients. Les résultats ont toutefois indiqué que les observateurs ont diminué l'utilisation des stéréotypes et ont augmenté l'utilisation des comportements de douleur lorsque le doute a été soulevé et qu'ils ont été invités à juger le niveau d'authenticité des patients. Des analyses subséquentes ont révélé que les observateurs ont utilisé significativement plus les comportements de communication que les comportements de protection lorsqu'ils ont effectué des jugements quant à l'authenticité de la douleur des patients.
21
Mcdougall, Fiona. « How do partners' beliefs about chronic pain relate to patients' acceptance of pain ? » Thesis, University of East Anglia, 2012. https://ueaeprints.uea.ac.uk/47284/.
Texte intégralRésumé :
Background: It is now widely acknowledged that pain acceptance predicts a wide range of functional outcomes in chronic pain patients. Whilst there has been considerable research into individual factors that contribute to acceptance, little is known about the impact of social relationships on this process. Aims: This thesis aims to explore how spouse’s beliefs about pain, and their responses to patients when in pain, impact on patient acceptance. Second, the role of catastrophic thinking and acceptance will be explored in relation to psychological distress. Method: A cross-sectional survey design was used with 61 patients and their partners recruited at a specialist chronic pain service. Patients completed the Chronic Pain Acceptance Questionnaire, the Pain Catastrophising Scale, and the Hospital Anxiety and Depression Scale in addition to measures of pain severity, functional disability, and socio-demographic information. Partners completed the spouse version of the Pain Catastrophising Scale which explores their beliefs about their partner’s pain. Results: Both depressive and anxious symptoms were common in this sample, with 49% and 58% respectively experiencing at least mild symptoms. Pain catastrophising and acceptance scores were significantly correlated with psychological distress, functional disability and pain severity. After adjusting for confounders, the CPAQ was a significant predictor of depression but not anxiety. Pain catastrophising was a significant predictor of both depression and anxiety. The addition of spouse catastrophising significantly improved the model for the prediction of anxiety. Patient and spouse catastrophising scores were both significant independent predictors of acceptance after adjusting for confounders. There was a significant effect of the interaction between patient and spouse catastrophising on acceptance, such that when patient catastrophising was low, low catastrophising in spouses was associated with greater acceptance, but when patient catastrophising was high, catastrophising in spouses had no effect. Neither the CPAQ total score nor its subscales were significantly correlated with spouse responses to pain. Conclusions: These findings suggest that spouse catastrophising can impact on both patient acceptance and psychological distress. Understanding a spouse’s beliefs about their partner’s pain may be an important factor in achieving greater acceptance in patients.
22
Coupar, Alan. « Evaluation of a cognitive-behavioural pain management programme with severely chronic pain patients ». Thesis, Bangor University, 1996. https://research.bangor.ac.uk/portal/en/theses/evaluation-of-a-cognitivebehavioural-pain-management-programme-with-severely-chronic-pain-patients(b759a33f-56bf-4093-927f-ded06e678ded).html.
Texte intégralRésumé :
Cognitive-behavioural group therapy, and self-help materials are frequently used in therapy with chronic pain patients, but have received little systematic investigation when used with severely disturbed chronic pain patients. The present study stands in contrast to others working with more selected groups. Patients investigated here had severe psychological problems, particularly depression in addition to high levels of chronic pain and disability. Self-help materials were provided before group therapy. Therapeutic interventions were evaluated by McGill Pain, Oswestry Disability and Pain Locus of Control Questionnaires, B. D. I., self-recording diary episodes and memory recall test. No significant changes in pain or disability measures were found, but there were significant cognitive changes as assessed by raised control and memory for nonpain words. . Assessments which predicted change were also identified. The need to match interventions to individuals, limitations of group therapy with highly disturbed individuals and the importance of multidisciplinary work for success are noted. The results are discussed within a development of the transitional model described by Karoly and Jensen (1987).
23
Kung, Francis Tat-yan. « Chronic pain in older people ». Connect to thesis Connect to thesis, 2001. http://adt1.lib.unimelb.edu.au/adt-root/public/adt-VU2001.0028/index.html.
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24
Törnkvist, Lena. « Care by districts nurses : management of patients with chronic-pain conditions, patient satisfaction and effects of pain advisers / ». Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4762-7/.
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DeCelie, Irene Lane. « The relationship between a pain management program and chronic pain in patients with cancer / ». Staten Island, N.Y. : [s.n.], 1994. http://library.wagner.edu/theses/nursing/1994/thesis_nur_1994_decel_relat.pdf.
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Knight, Paul D. « Understanding pain, trauma and posttraumatic stress in patients with chronic pain : A translational investigation ». Thesis, Knight, Paul D. ORCID : 0000-0001-5276-2910 (2019) Understanding pain, trauma and posttraumatic stress in patients with chronic pain : A translational investigation. PhD thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/53873/.
Texte intégralRésumé :
Background. Interdisciplinary chronic pain management programmes are costly and effective for many participants. However, it remains a conundrum as to why a substantial proportion of patients do not make clinically significant improvements in mood and functioning.
Aims. This programme of research takes a translational, mixed methods approach to addressing this question, triangulating a series of interconnected basic research studies with evaluation of intervention, in combination, to: (i) explore the association between posttraumatic stress in chronic pain patients and objectively assessable event characteristics (injury severity, cause of pain (trauma- or non-trauma related), time in pain (sub-acute or chronic); and aspects of subjective patient experience of pain (complete or partial memory of the event; diffuse or specific pain); (ii) investigate developmental aspects of the co-evolution of pain and distress by exploring clinically relevant posttraumatic stress between subacute and chronic pain patients; (iii) investigate the impact of trauma on injury recovery by exploring psychological sequelae of trauma-induced compared to non-trauma related pain; (iv) explore broader premorbid and acute contextual factors impacting recovery by undertaking a case analysis of patients’ view of their lives and the impact on pain self-management.
Method. In a series of five studies, chronic pain participants whose pain was traumatic in origin (N=64) were compared with both a subacute traumatic pain group (N=77) and a chronic non-traumatic pain group (N=88). A qualitative study (N=10) further investigated the impact of social history on pain self-management.
Results. All groups reported significant (but similar) rates of posttraumatic stress. Further, compared to the subacute group, chronic groups reported higher rates of diffuse pain, and complete memory of their pain event. Type of pain event, injury severity scores, and gender were not associated with clinically relevant posttraumatic stress in any group. In the subacute group, a significant relationship was found between distress and partial memory of the pain event. The qualitative case study found that participants’ unique histories contributed to “self-rules” that provided a premorbid lens through which their pain was interpreted, and their pain response was informed.
Conclusion. Posttraumatic stress is a significant feature of chronic pain and is already evident in the subacute phase of recovery. Vulnerability to, and maintenance of, pain and traumatic distress cannot be understood purely through the lens of objective event characteristics though these are the indices routinely collected by health experts. The subjective experience of pain holds more hope for predicting psychological outcomes. Collection of this information during hospital screening may afford a means of making more judicious judgements about resource allocation, access to services, and ultimately may provide an evidence base to inform a personalized medicine approach to treatment planning.
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Keter, Elinor. « A thematic cognitive behavioural intervention with depressed chronic pain patients ». Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0004/MQ32153.pdf.
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趙帶榮 et Tai-wing Chiu. « The efficacy of exercise for patients with chronic neck pain ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31243034.
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Levell, Jayne. « Response expectancy for spinal cord stimulation in chronic pain patients ». Thesis, University of Leeds, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275556.
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Sumner, Anne Elizabeth. « A thematic exploration of chronic pain as described by patients ». Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/10997.
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Includes bibliographical references (leaves 65-67).This study explores the experience of people suffering from chronic pain post surgical interventions. Cases are selected from those patients currently attending a pain clinic. By means of five in-depth, unstructured interviews this research seeks to understand how these patients view their pain. Recurrent themes arising emanating from these interviews are identified and then examined. These include: the breakdown in the doctor-patient relationship, and the all pervasive nature and effect of pain on the lives of those suffering from chronic pain. This research recommends that doctors should begin to examine the part they may play in the aeitiology of chronic pain. A practical aspect of this might be the rotation of student doctors through chronic pain clinics.
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Chiu, Tai-wing. « The efficacy of exercise for patients with chronic neck pain / ». Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2520516x.
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Farris, Gloria Jean. « Screening for Opioid Misuse and Abuse in Chronic Pain Patients ». ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3940.
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Abstract
In 2012, opioid prescriptions exceeded 250 million, which is equivalent to providing a prescription to every adult in the United States. Prescription opioids have contributed to over 100,000 deaths since the late 1990s with the greatest impact among adults 35 through 54 years of age. The purpose of this doctoral project was to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. The Screener and Opioid Assessments for Patients with Pain (SOAPP), a screening tool, was given to 100 participants, both males and females between the ages of 25 and 65, in an outpatient pain clinic. The data collection method was a questionnaire consisting of 14 questions designed to predict behaviors of people using opioids for chronic pain. Participant questionnaire responses on the Likert-5-point scale of 0 (Never), 1 (Seldom), 2 (Sometimes), 3 (Often), and 4 (Very Often) were totaled with a score of 7 or above indicating a high risk for abuse. Once the SOAPP data were obtained scores were calculated and grouped into categories of low or high risk for opioid misuse or abuse. Results indicated that 25% of the participants scored at high risk for opioid misuse (22% were female and 27% male) implying that there was a need for additional monitoring by the physician and nurse practitioner. The mean age for high risk was 51 and for low risk 54. Pain management providers play a crucial role in the effectiveness and success of the patient's treatment. Positive social change may occur when assessment tools such as the SOAPP are used in the evaluation and management of patients with chronic pain and addiction.
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Clair, Mark Alan. « Reflex sympathetic dystrophy : A task-related electroencephalographic analysis in chronic pain patients ». CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1245.
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Alamgir, A. S. F. « Exploring the relationship between acceptance and catastrophising in pain beliefs in patients with chronic pain ». Thesis, University of Essex, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446020.
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Trowell, Vanessa. « Dilemmas in talk about chronic pain : analysis of patients' and medical professionals' accounts of pain ». Thesis, Lancaster University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274271.
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Lindvall, Agnes, et Ana Chilaika. « CHRONIC PAIN A study on patients with chronic pain : What characteristics/variables lie behind the fact that a patient does not respond well to treatment ? » Thesis, Uppsala universitet, Statistiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-254493.
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The primary purpose of this study was to find out which variables lie behind the fact that patients who respond well to treatment of chronic pain differs from those who do not. We used logistic regression to predict group belonging based on the self-reported health surveys, i.e if different answers in the surveys can predict whether a patient is “responsive” or “unresponsive”. By bootstrapping 176 samples, and aggregating the results from 176 logistic regressions based on the sub-samples, we calculate an averaged model. The variables anxiety and physical health were significant in 76% and 70% of the models respectively, while depression was significant in 30% of the models. Gender was significant in 15% of the models and health status in 0,006%. The averaged model correctly classified the most unresponsive patients at cut-off value 0.5. As the cut –off value was increased, the number of correctly classified unresponsive patients decreased while the number of correctly classified responsive patients increased, as well as unresponsive patients classified as responsive. We concluded that the model did not discriminate enough between the two groups. We were also interested in finding out how the variables anxiety, depression, heath status, willingness to participate in activities as well as engagement in activities, mental and physical health relate with one another. The results from confirmatory factor analysis showed that a patient’s health status is highly related to their physical health and activity engagement while pain willingness and engagement in activity were least related. Furthermore, the analysis showed that mental health is highly related with anxiety and health status, indicating that mental health is indeed important to reflect upon when considering the health status of a patient.
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Patrick, Louise. « Expressed support, perceived support and physical ability in chronic pain patients ». Thesis, University of Ottawa (Canada), 1992. http://hdl.handle.net/10393/7783.
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This study investigated the relationship between social support within the marital context, and physical ability in chronic pain patients. Fifty patients diagnosed with chronic pain and their spouses participated in the study. Each patient was asked to exercise on a stationary bicycle, with his/her spouse present. The interactions between patient and spouse were videorecorded and the spouse's behaviour was rated for the amount of task-related and emotional support expressed. The relationships among the spouse's behaviour, the patient's perception of that behaviour and the patient's physical ability were examined. Marital adjustment, depressive symptomatology and the spouse's perception of the patient's physical limitations were investigated as predictors of expressed and perceived support. Zero-order correlations replicated the previously demonstrated positive relationships among the patient's report of spouse support, pain intensity and marital adjustment. Using hierarchical regression to control for the patient's depressive symptomatology and marital adjustment, it was found that observed spouse support was positively related to the patient's physical ability, accounting for 13% of the variance. When pain severity was also entered into the equation, results indicated that pain intensity was the only significant predictor and was negatively related to the patient's physical ability, accounting for 43% of the variance. No significant predictor of the spouse's expressed support was identified, while the patient's marital adjustment was positively related to his/her perception of support. Descriptive reports by patients of their perception of support during the physical ability task indicated that patients experienced task and emotional support differently. The majority of patients reported that emotional support was experienced as supportive and helpful, but task-related support was not.
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Kool, Jan Pieter. « Physiotherapy and sick leave in patients with chronic low back pain ». [Maastricht] : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 2005. http://arno.unimaas.nl/show.cgi?fid=6532.
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Nygren, Karin, et Charlotte Glimstedt. « Pain modulation in patients with chronic lumbar myalgia : An experimental study ». Thesis, Linnéuniversitetet, Institutionen för idrottsvetenskap (ID), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-26833.
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Syfte: Syftet med denna studie var att undersöka hur statisk muskelkontraktion och cold pressor test påverkar kroppsegna smärtreglerande system (”Exercise induced analgesia” (EIA) och ”Conditioned pain modulation” (CPM)) hos patienter med kronisk ländryggssmärta kännetecknad av lumbal myalgi (LM) jämfört med friska kontroller. Försökspersoner och metod: Tjugosex friska köns- och åldersmatchade personer och tjugosex LM-patienter deltog. De utförde standardiserad statisk muskelkontraktion med m. Erector spinae (ME) i form av rygglyft och kontraktion av m. Quadriceps femoris (MQ) i form av knäledsextension. För att bedöma CPM användes sk cold pressor test. Smärttrösklar för tryck (PPTs) mättes över m. Deltoideus (MD), m. Erector spinae (ME) samt över m. Quadriceps (MQ) i vila och under resp. efter kontraktionen/cold pressor test. Under kontraktion mättes PPTs över den arbetande muskeln respektive över de två vilande musklerna. Dessutom undersöktes PPTs och känsligheten för övertrösklig trycksmärta (P7) i vila på 8 olika punkter på kroppen. Resultat: Kvinnliga LM-patienter hade ökad känslighet för trycksmärta (PPT) och övertrösklig trycksmärta (P7) jämfört med köns- och åldermatchade friska kontroller, medan manliga LM-patienter paradoxalt nog hade minskad känslighet för övertrösklig trycksmärta. Beträffande EIA fann vi att LM-patienter och kontroller kunde aktivera lokal EIA under kontraktion med ME. Vi fann dessutom en minskad förmåga hos LM-patienter att rekrytera generaliserad EIA under kontraktion med MQ. Slutligen hade LM-patienterna en normal funktion av CPM. Slutsats: LM-patienter kunde aktivera lokal EIA under kontraktion av ME, men hade mindre effektiv generaliserad EIA jämfört med kontrollerna, trots normal funktion av CPM. Våra resultat tyder på att muskelarbete med smärtande ryggmuskler skulle kunna användas för att minska smärtkänslighet i det drabbade området.
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Rofail, Diana. « Treatment satisfaction and dissatisfaction in patients with chronic low back pain ». Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/4616.
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This thesis explores treatment satisfaction and dissatisfaction in patients with chronic low back pain (CLBP). Chapters 1 and 2 provide background on CLBP, and treatment satisfaction and dissatisfaction. Chapter 3 presents study 1, the systematic review which identified research concerning treatment satisfaction and dissatisfaction in patients with CLBP. Findings indicated a need to define the concept, and establish appropriate measurement based on patient input and evidence to support the reliability and validity of items. Chapter 4 presents study 2, a qualitative study. Ten patients with CLBP taking medication and/or receiving physiotherapy were interviewed. A conceptual model of CLBP and a thematic map of treatment satisfaction and dissatisfaction were developed. Satisfaction was related to being 'happy' or 'pleased', and maintaining normal functioning. Treatment not working, causing discomfort, or negatively affecting health-related quality of life, as well as inconvenience of medication, lack of information, not feeling involved in treatment decisions, lack of trust and confidence in healthcare professionals, and being misdiagnosed or undiagnosed, were associated with dissatisfaction. Chapter 5 documents the development of the CLBP Treatment Satisfaction Questionnaire, based on patient input from study 2. Cognitive debriefing showed items were relevant and understood by patients. Chapter 6, study 3, explored the psychometric properties of the questionnaire. The longitudinal design involved data collection from 249 patients, some of whom participated in follow-ups. Results indicated that treatment satisfaction/dissatisfaction involves an appraisal of the following seven domains: 'Information Provided about Back Pain and Treatment', 'Burden of Back Pain', 'Impact of Back Pain and Treatment on Relationships', 'Satisfaction with the Treatment Process', 'Problems with Side Effects of Medication', 'Adherence to Physiotherapy', and 'Medication Acceptability'. Some evidence of reliability and validity are presented. This thesis concludes with Chapter 7, a discussion of the main findings of the studies, strengths and limitations, and recommendations for future research.
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Burroughs, Ramona D. « Quantitative EEG Analysis of Patients with Chronic Pain : An Exploratory Study ». Thesis, University of North Texas, 2011. https://digital.library.unt.edu/ark:/67531/metadc103294/.
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This study examined quantitative EEGs of six individuals with chronic pain and compared them to an age- and gender-matched normative database of healthy control subjects in an attempt to discern whether a particular pattern of resting state EEG activity is associated with chronic pain. In the chronic pain group, significantly reduced absolute power was seen in delta and theta bandwidths at frontal sites in the eyes-closed condition. In the eyes-open condition, significantly reduced absolute power was seen in delta, theta, and alpha bandwidths at frontal, central, and temporal sites, and increased relative high beta power was seen in the parietal region. Reduced theta/high beta and delta/high beta ratios were seen in the parietal region. Quantitative EEG neuromarkers of chronic pain are suggested.
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Turesky, Derek Geoffrey. « A descriptive analysis of alexithymia among patients with chronic back pain ». Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/1272.
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Chronic back pain is a pervasive and debilitating phenomenon contributing to staggering health costs and a host of psychological, medical, vocational, and social consequences. The etiology of chronic back pain remains unclear and traditional biomedical, psychological, and interdisciplinary treatments have not been completely effective at eliminating pain or restoring long-term functionality. Psychodynamic models of chronic back pain have not been fully explored due to methodological difficulties. Explorations of psychodynamic-related constructs such as alexithymia (i.e., lack of emotional awareness) may offer vital clues to help increase the understanding of chronic back pain. The purpose of this study was to serve as a preliminary descriptive analysis of alexithymia among patients seeking interdisciplinary treatment for chronic back pain. First, the prevalence of alexithymia in an interdisciplinary treatment seeking sample of patients with chronic back pain and comparisons to other chronic pain and psychosomatic samples were addressed. Second, the relationship between alexithymia and somatic complaints, pain, anxiety, depression, and health-related quality of life was explored. Finally, a meditational analysis was conducted to examine if the relationship between alexithymia and somatic complaints was mediated by negative affect. Eighty-one patients seeking interdisciplinary treatment for chronic back pain participated in the study. Analyses revealed that 14.8% patients met criteria for alexithymia, which was similar to other chronic pain samples but not significantly different from general medical samples. Higher alexithymia scores were found to be associated with higher levels of somatic complaints, negative affect, and mental-health related quality of life. Unexpectedly, higher alexithymia scores were also associated with better physical-related quality of life. There were no significant relationships between alexithymia and pain. The relationship between alexithymia and somatic complaints was found to be mediated by negative affect, which was consistent with psychodynamic models of chronic back pain. Findings were discussed in relation to clinical implications and future research.
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Wit, Adriana de. « Cancer pain & ; how to relieve it effects of a pain education program in cancer patients with chronic pain / ». Maastricht : Maastricht : Universiteit Maastricht ; University Library, Maastricht University [Host], 1999. http://arno.unimaas.nl/show.cgi?fid=7192.
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Abdel-Moty, Alma R. « Stated versus observed performance levels in patients with chronic low back pain ». FIU Digital Commons, 1992. http://digitalcommons.fiu.edu/etd/1079.
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This study examined the relationship between chronic low back pain (CLBP) patients' perceived (stated) levels of function and their measured (observed) performance in squatting and stair climbing activities as compared to healthy volunteers. Twenty patients with CLBP and 20 healthy subjects were asked through an interview to self-assess their ability to comfortably perform stair climbing and squatting as well as other tolerances. The subjects were then asked to perform the activities and their performance levels were recorded. Results of the t-tests and Analysis of Variance (ANOVA) procedures revealed that patients' estimate of squatting and stair climbing abilities as well as their demonstrated levels were significantly lower (p < 0.001) than those of the healthy subjects. There was a significant difference between groups in terms of the time required to perform squatting but not stair climbing. Both healthy subjects and patients with CLBP underestimated their physical capabilities. Findings indicate that the use of actual performance measurement combined with self-report of functional abilities is needed when assessing performance levels of both healthy as well as patients with CLBP.
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Abbey, Hilary Amanda. « Developing an integrated osteopathy and acceptance-informed pain management course for patients with persistent pain ». Thesis, University of Bedfordshire, 2017. http://hdl.handle.net/10547/622497.
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Purpose: This study explored therapeutic processes associated with developing a course for patients with persistent pain which integrated osteopathic treatment with Acceptance and Commitment Therapy (ACT). This 'third wave’ cognitive behavioural approach is effective for a range of physical and psychological problems, including persistent pain, and congruent with osteopathic principles of holism, function and agency, which provided a theoretical basis for developing an integrated intervention to promote resilience and well-being. A qualitative case study was conducted as part of a developmental research programme to explore how ACT could be integrated with osteopathic treatment for individual patients, and with what effects on processes and outcomes. Method: Linguistic ethnography was used to explore links between pain-related discourses, clinical decisions and responses to pain. Treatments were audio-recorded, transcribed, and coded. Extracts referring to discourses about pain experienced during manual therapy were subjected to micro-level conversation analysis, sociolinguistic analysis of participants’ roles, and macro-level analysis of links to broader healthcare discourses. A reflective diary was used to explore experiential learning and integrate auto-ethnographic information. Results: Two distinctive forms of mechanistic and facilitative pain discourse were identified. In predominantly mechanistic discourses, agency and expertise were located with the osteopath, and intention was focused on fixing ‘broken’ parts and relieving pain using ‘familiar’ osteopathic techniques. In facilitative discourses, the osteopath adopted a more collaborative role, focused on developing the patient's body and self-awareness to promote more flexible, active pain responses. Practitioner challenges included learning how to shift intention between mechanistic and facilitative interventions, a process that was enabled by mindfulness and willingness to tolerate uncertainty. Conclusions: In this study, ACT-informed osteopathy involved facilitative discourses, associated with increased patient agency and flexibility in response to pain. Further research is needed to explore whether this pattern of discourse is robust in other clinical settings; relationships between mechanistic and facilitative discourses and therapeutic outcomes; and effects of ACT training on practitioner mindfulness and attitude towards clinical uncertainty. Findings suggest that this integrated approach could expand the scope of osteopathic care for patients with persistent pain, and is worth further investigation.
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Rispinto, Sarah C. « Treatment Outcomes of Patients with Low Back Pain Treated in a Pain Rehabilitation Program ». Cleveland State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=csu1409235938.
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Babson, Lisabeth Jean Currier. « Effectiveness of self-monitoring of negative self-statements with chronic pain patients ». Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1195144188.
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Henson, C. D. (Connie Dee). « The Use of Coping Strategies in Depressed and Nondepressed Chronic Pain Patients ». Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc277985/.
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This study investigated the relationship between preferred coping strategies, and major stressors for nondepressed, and depressed chronic pain patients. The subjects for this study were 67 chronic pain patients who are participating in a pain/spinal rehabilitation program. The information collected from the individuals or their records included: (1) basic demographic information, (2) level of activity, (3) level of perceived pain, (4) medication usage, (5) therapist rating of level of stabilization, (6) scores on three inventories including the Coping Strategies Questionnaire, the Ways of Coping Checklist, and the Beck Depression Inventory. Analyses included an examination of the relationship between level of depression and (1) type of stressors, (2) coping strategies, and (3) level of perceived pain. Further analyses included multiple regression with outcome as defined by therapist ratings at the end of treatment, and patients' ratings at follow up as the criterion variables.
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Nickel, James Allen. « Multivariate clustering of chronic pain patients : a replication using the MMPI-2 ». Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/862282.
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This study addresses the problem of assessment of chronic pain patients, a population with special needs which have only begun to be recognized by the medical community. While this paper promotes a comprehensive approach to assessment and treatment of chronic pain patients, the research questions in this study specifically address assessment of personality and its relationship to other biopsychosocial variables.The purpose of the study was to replicate cluster analyses done with the Minnesota Multiphasic Personality Inventory (MMPI) in chronic pain patient populations using the revised and re-nonmed Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and. secondly, to identify other variables which are associated with particular personality profile patterns in chronic pain patients.This study examines the archival records of approximately 300 male and female, chronic pain patients who were seen at a hospital-based, multidisciplinary, outpatient pain management clinic from 1989 to 1992. Information analyzed includes The (MMPI), and the Patient Assessment Inventory and Narrative (PAIN), an instrument used at the pain clinic, designed to collect demographic, social, and vocational information, medical history, and cognitive, emotional, and sensory-perceptual characteristics of the patient's pain experience.The data from the MM PI-2 scales was cluster analyzed, yielding three homogeneous profile subgroups for both male and female samples, as well as the full sample. These groups corresponded closely to those found in earlier MMPI research with chronic pain patients. A discriminant analysis was used to examine which combinations of other biopsychosocial variables best explained the differences between each of the groups of patients derived in the cluster analysis. Results indicate that a combination of "negative life-impact" variables most significantly distinguished between the derived groups. Analysis of variance (ANOVA) using Tukey's HSD procedure revealed how each group differed-on the "negative life-impact" spectrum, with more elevated MMPI-2 profiles showing greater negative life-impact and less elevated profiles showing less negative life-impact. Implications and limitations of the study, as well as recommendations for future research are discussed.Department of Counseling Psychology and Guidance Services
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Laird, Michelle. « Impact of Pretreatment Self-Perceived Quality of Life on Chronic Pain Patients ». ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1692.
Texte intégralRésumé :
Researchers and practitioners have developed new treatment options for chronic pain management based on biopsychosocial models of pain known as interdisciplinary pain management programs (IPMP), which involve interdisciplinary care that integrates physical treatment with emotional, environmental, behavioral, and cognitive interventions. Despite literature documenting the effectiveness of IPMPs, patients find it difficult to obtain authorization for these programs from third party insurance payers. The purpose of this quantitative causal comparative study was to explore whether a patient's perceived quality of life after injury but prior to treatment will affect his or her success in an IPMP. This study was based in the theoretical foundations of the biopsychosocial model of pain as well as positive psychology. Regression analysis and a test of mean differences were used to analyze the data to determine if there was a statistically significant difference in the perceived success in an IPMP program between patients who were part of a workers' compensation program (n = 77) and those who were not (n = 60). None of the null hypotheses could be rejected. Quality of Life Index (QOLI) scores were not predictive of success in an IPMP. None of the QOLI 16 subscales were predictive of success in an IPMP. Additionally, there was no significant difference between patients who were on workers' compensation and those who were not. This study contributes to the knowledge gap regarding appropriate screening tools for admittance into an IPMP. The results of this study can be used by practitioners who are trying to get patients approved for an IPMP and by third party insurance payer when determining which patients would most benefit from attending an IPMP.